Prolotherapy for TMJ and TMD

A common area forgotten in headache and neck pain is the temporomandibular joint. The temporomandibular joint (TMJ) is the physical connection where the jaw meets the skull. The TMJ is necessary to keep the jaw in proper alignment, especially when talking and eating. A painful and clicking TMJ is called temporomandibular joint syndrome (TMJS). The symptoms of TMJS are essentially the same as cervicocranial syndrome. It is our belief that the symptoms, such as dizziness, vertigo, etc., that physicians ascribe to TMJS, are actually due to cervicocranial syndrome/ Barré-Lieou syndrome.

Causes of TMJ Syndrome

Typically in TMJS the lower jaw (mandible) is extended forward. A head forward posture exaggerates the problem. This forward mandible aggravates the cervical ligament laxity, which increases the neck pain. Again, an endless cycle of pain and disability is created in the neck, head, and face region. Prolotherapy injections to strengthen both the cervical vertebrae and the temporomandibular joint will solve this problem.

Eventually, the mandible moves forward to the extent that it will stretch the lateral TMJ ligament and produce pain. Once the lateral TMJ ligament becomes lax, the joint will click. It is important to note that clicking in any joint is an indication of ligament laxity of that joint. Joint clicking is never normal or a good sign. Joint clicking, whether it is in the TMJ, knee, neck, or lower back is always abnormal. It is a sign that the bones are beginning to rub against each other. The body’s compensatory mechanism for such a situation is to tighten muscles and to grow more bone. The end result will be degeneration, arthritis, and stiffness in that joint. Prolotherapy can stop this process. Prolotherapy will stop a joint from clicking and stop the arthritic process from continuing.

Another cause of lax TMJ ligament is the patient’s sleeping position. For example, if a patient sleeps with his or her head turned to the right, the TMJ on the left side will be continually stretched throughout the night. Over many decades, continually sleeping in this manner puts the left TMJ at risk for TMJ ligament laxity. The patient with a TMJ problem is advised to sleep with the head turned to the side of the problematic TMJ.

A patient came to Caring Medical with one of the worst cases of TMJS we have ever seen. His jaw popped so loudly that the action of opening his mouth could be heard in the other room. The first Prolotherapy session to his TMJ caused a 60% reduction in the clicking of his jaw. After the second treatment, the clicking was eliminated completely. Terry told us that his dentist was amazed. Most dentists and oral surgeons believe TMJ syndrome is permanent and the best hope is for temporary symptom relief. We can verify in our own practice that TMJ syndrome can be cured with Prolotherapy. By the way, did the dentist call us to find out what we did to finally help Terry find relief? No, they never do.

Treatment of TMJ Syndrome

Louis Schultz, MD, an oral surgeon, reported in 1956 that after 20 years of experience in treating hypermobile temporomandibular joints with Prolotherapy, the clicking, grating, or popping was controlled in all of the several thousand patients that had been under his care, without any reported complications or deleterious effects.1,2

Other Prolotherapists have noted similar improvements in their patients.3-4 In our study, published in Practical Pain Management, we reported on 14 patients with TMJ pain. The average number of treatments received was 4.6, and the average pain level decreased from 5.9 to 2.5, on a scale of 1-10.5

Prolotherapy solution is injected into and around the temporomandibular joint. The patient is placed on a soft diet until the mouth is able to fully open. The TMJ Prolotherapy injections cause an awkward bite and a tight jaw for a couple of days. The patient should not force the mouth open during this time period.

Options now available for people with head and neck pain are TMJ arthroscopic surgery, TMJ implants, cervical spine surgery (many varieties), botulism toxin injections into muscles,6 and surgical cauterization, which zaps the bones with a radiofrequency wave, destroying the treated area.7 This last technique may eliminate a patient’s pain because it destroys the fibro-osseous junction, where the pain originates. Why destroy or remove a structure when there is a treatment that will help strengthen and repair it?